Five Talent Accrete India

Position Description: We are seeking a highly skilled and motivated individual to join our healthcare organization as a Medical Credentialing Specialist with a strong background in project management. In this crucial role, you will be responsible for overseeing the credentialing process for healthcare providers, ensuring compliance with industry standards, and optimizing workflow through effective project management strategies. Position Duties : 1. Credentialing Oversight: Manage the end-to-end credentialing process for healthcare providers, including initial applications, re-credentialing, and ongoing monitoring. Stay abreast of industry regulations and accreditation standards to ensure compliance in all credentialing activities. Collaborate with internal departments to gather necessary documentation and information for credentialing purposes. 2. Project Management: Utilize project management methodologies to streamline and enhance the credentialing process. Develop and implement project plans, timelines, and milestones to ensure efficient and timely completion of credentialing tasks. Identify and address bottlenecks in the credentialing workflow through effective project management strategies. 3. Quality Assurance: Conduct regular audits and quality checks to verify the accuracy and completeness of credentialing files. Implement continuous improvement initiatives to enhance the efficiency and effectiveness of the credentialing process. 4. Communication and Collaboration: Communicate effectively with healthcare providers, internal staff, and external organizations to gather necessary information and resolve credentialing issues. Collaborate with cross-functional teams to integrate credentialing processes seamlessly with other organizational functions. Position Requirements: 1. Education and Certification: Bachelor's degree in healthcare administration, business, or related field. Certified Provider Credentialing Specialist (CPCS) or Certified Professional in Medical Services Management (CPMSM) certification is preferred. 2. Experience: Minimum of 3 years of experience in medical credentialing. Proven track record in project management, with experience in developing and implementing project plans. 3. Knowledge and Skills: In-depth understanding of credentialing standards, regulations, and best practices. Strong project management skills with the ability to manage multiple projects simultaneously. Excellent organizational and analytical skills, with attention to detail. 4. Communication Skills: Exceptional written and verbal communication skills. Ability to effectively communicate with internal and external stakeholders. 5. Technology Proficiency: Proficient in using credentialing software and Microsoft Office Suite. 6. Adaptability: Ability to adapt to changes in regulations and industry standards. Willingness to embrace new technologies and methodologies for process improvement.